Immediate endoscopic management of complete iatrogenic anterior urethral injuries: A case series with long-term results

BACKGROUND: Urethral injury produces partial or complete disruption of the urethral integrity. Advances in endourology have made endoscopic management of most of these injuries feasible without greatly compromising the final result. We report our institutional experience of immediate endoscopic realignment of complete iatrogenic anterior urethral injury. METHODS: From May 1997 to May 2003, seven patients with complete anterior urethral disruption were managed by immediate endoscopy guided splinting of urethra. Retrograde urethroscopy, combined with fluoroscopic guidance and in some cases antegrade cystoscopy through a suprapubic stab cystostomy was performed. A guide wire was negotiated across the disruption. Later, a 16 F Foley catheter was placed for 1–3 weeks. Patients were followed up at 1, 3, 6 and 12 months and then yearly to assess the long-term outcome of endoscopic management. RESULTS: Immediate endoscopic realignment was achieved in all patients. Three patients developed recurrence at six months; that was treated by optical urethrotomy. Only one patient developed multiple recurrences over an average follow-up of 49.2 months (range 7 to 74 months). He was offered open end-to-end urethroplasty at twenty months after third recurrence. Thus immediate endoscopic realignment avoided any further intervention in four patients (57.14%); while after an additional optical urethrotomy, urethroplasty could be avoided in six patients (87.2%). CONCLUSION: Immediate endoscopic realignment of traumatic urethral disruption is a feasible, safe and effective treatment modality for management of patients with iatrogenic complete anterior urethral injuries

Attenuation of the Sensing Capabilities of PhoQ in Transition to Obligate Insect–Bacterial Association

Sodalis glossinidius, a maternally inherited endosymbiont of the tsetse fly, maintains genes encoding homologues of the PhoP-PhoQ two-component regulatory system. This two-component system has been extensively studied in facultative bacterial pathogens and is known to serve as an environmental magnesium sensor and a regulator of key virulence determinants. In the current study, we show that the inactivation of the response regulator, phoP, renders S. glossinidius sensitive to insect derived cationic antimicrobial peptides (AMPs). The resulting mutant strain displays reduced expression of genes involved in the structural modification of lipid A that facilitates resistance to AMPs. In addition, the inactivation of phoP alters the expression of type-III secretion system (TTSS) genes encoded within three distinct chromosomal regions, indicating that PhoP-PhoQ also serves as a master regulator of TTSS gene expression. In the absence of phoP, S. glossinidius is unable to superinfect either its natural tsetse fly host or a closely related hippoboscid louse fly. Furthermore, we show that the S. glossinidius PhoQ sensor kinase has undergone functional adaptations that result in a substantially diminished ability to sense ancestral signals. The loss of PhoQ's sensory capability is predicted to represent a novel adaptation to the static symbiotic lifestyle, allowing S. glossinidius to constitutively express genes that facilitate resistance to host derived AMPs

Compromiso organizacional y satisfacción laboral: un estudio exploratorio en unidades de salud familiar portuguesas

Explorou-se a relação entre compromisso organizacional e satisfação laboral nos colaboradores de unidades de saúde familiar. Participaram seis unidades de saúde familiar do norte de Portugal e 105 profissionais (médico, enfermeiros e secretários clínicos). Utilizaram-se as adaptações portuguesas da Escala do Compromisso Organizacional de Meyer & Allen (1997) e do Questionário de Satisfação com o Trabalho (Spector, 1985). Os resultados sugerem associação positiva entre compromisso organizacional e satisfação laboral. Os profissionais estão moderadamente satisfeitos e comprometidos com as unidades de saúde familiar, sendo a natureza do trabalho, a relação com os colegas e a comunicação os aspectos mais satisfatórios, e as recompensas o mais insatisfatório. A componente afetiva do compromisso evidencia-se, salientando o envolvimento e a identificação dos profissionais com o projeto unidades de saúde familiar. O modelo de regressão linear revelou-se significativo, o compromisso organizacional explica 22,7% da variância da satisfação com o trabalho. Para esta amostra, o compromisso organizacional prediz a satisfação com o trabalho.This study explored the relationship between organizational commitment and job satisfaction among workers in family health units. Six family health units in the North of Portugal participated, including 105 health professionals (physicians, nurses, and clinical secretaries). The study used the Portuguese adaptations of the Organizational Commitment Scale by Meyer & Allen (1997) and the Job Satisfaction Survey (Spector, 1985). The results suggest a positive association between organizational commitment and job satisfaction. The professionals are moderately satisfied and committed to the family health units; the most satisfactory aspects are the nature of the work, relationship to coworkers, and communication, while pay is the most unsatisfactory. The affective component of the commitment appears, highlighting the professionals' involvement in (and identification with) the family health units project. The linear regression model proved significant, and organizational commitment explains 22.7% of the variance in job satisfaction. For this sample, organizational commitment predicts job satisfaction.Instituto Nacional de Saúde Dr Ricardo Jorgeinfo:eu-repo/semantics/publishedVersio

Origin and Examination of a Leafhopper Facultative Endosymbiont

Eukaryotes engage in intimate interactions with microbes that range in age and type of association. Although many conspicuous examples of ancient insect associates are studied (e.g., Buchneraaphidicola), fewer examples of younger associations are known. Here, we further characterize a recently evolved bacterial endosymbiont of the leafhopper Euscelidius variegatus (Hemiptera, Cicadellidae), called BEV. We found that BEV, continuously maintained in E. variegatus hosts at UC Berkeley since 1984, is vertically transmitted with high fidelity. Unlike many vertically transmitted, ancient endosymbioses, the BEV–E. variegatus association is not obligate for either partner, and BEV can be cultivated axenically. Sufficient BEV colonies were grown and harvested to estimate its genome size and provide a partial survey of the genome sequence. The BEV chromosome is about 3.8 Mbp, and there is evidence for an extrachromosomal element roughly 53 kb in size (e.g., prophage or plasmid). We sequenced 438 kb of unique short-insert clones, representing about 12% of the BEV genome. Nearly half of the gene fragments were similar to mobile DNA, including 15 distinct types of insertion sequences (IS). Analyses revealed that BEV not only shares virulence genes with plant pathogens, but also is closely related to the plant pathogenic genera Dickeya, Pectobacterium, and Brenneria. However, the slightly reduced genome size, abundance of mobile DNA, fastidious growth in culture, and efficient vertical transmission suggest that symbiosis with E. variegatus has had a significant impact on genome evolution in BEV

Group II Introns Break New Boundaries: Presence in a Bilaterian's Genome

Group II introns are ribozymes, removing themselves from their primary transcripts, as well as mobile genetic elements, transposing via an RNA intermediate, and are thought to be the ancestors of spliceosomal introns. Although common in bacteria and most eukaryotic organelles, they have never been reported in any bilaterian animal genome, organellar or nuclear. Here we report the first group II intron found in the mitochondrial genome of a bilaterian worm. This location is especially surprising, since animal mitochondrial genomes are generally distinct from those of plants, fungi, and protists by being small and compact, and so are viewed as being highly streamlined, perhaps as a result of strong selective pressures for fast replication while establishing germ plasm during early development. This intron is found in the mtDNA of an annelid worm, (an undescribed species of Nephtys), where the complete sequence revealed a 1819 bp group II intron inside the cox1 gene. We infer that this intron is the result of a recent horizontal gene transfer event from a viral or bacterial vector into the mitochondrial genome of Nephtys sp. Our findings hold implications for understanding mechanisms, constraints, and selective pressures that account for patterns of animal mitochondrial genome evolutio